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Organization
LAKEVIEW WOMENS HEALTH SC
Active
Organization
LAKEVIEW WOMENS HEALTH SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ILONA MARIE CARLOS MD (PRESIDENT)
(773) 871-1807
Entity
Organization
Contact information
Practice address
3000 N HALSTED, STE 709, CHICAGO, IL 60657-5196
(773) 871-1807
(773) 871-9954
Mailing address
3000 N HALSTED ST, STE 720, CHICAGO, IL 60657-5188
(773) 871-1807
(773) 871-9954
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01630320
BC/BS
—
01
—
501046
ADVOCATE
—
Enumeration date
01/03/2006
Last updated
04/09/2008
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